Mom's treatment...
 

Hi gang. I posted here one other time when my mom needed a change in her treatment. You were so supportive and helpful, I can't tell you how much I appreciate it. (Though I'm sure you know!)
Here's our latest issue: My mom has mets to the liver and is Her2 positive. She just finished a second round of Herceptin/Carbo/taxotere. She did
great on it. Went from 18 lesions in October down to four, and those
actually shrunk.
Her onc now wants to do Herceptin every 3 weeks and try
tamoxifin, which she hasn't been on to "buy more time."
She WAS on Femara after her first chemo for mets ended last year. She
was on this for about 5 months, then her 2 lesions turned into 18.
My question: Does this mean NO hormonals will work for her? I'm so
scared there aren't really any more options for her if the tamoxifin
doesn't work. I plan to call her doc tomorrow to talk to her myself, but
any guidance you can shoot my way, I'd really appreciate.
Thinking of you all, amy

Dear Amy:

Forgive me for my woeful lack of knowledge, but it is my understanding that hormonal therapies are for people who have PR+ or ER+ tumors. HER2 tumors are fundamentally different in the way they begin and grow than PR+ and ER+ tumors.

HER2 tumors are a result in a genetic mutation which causes cells to have too many growth receptors on the cell membranes of breast tissue. The growth receptors receive input as to when the cell should reproduce. If there are too many receptors, the genetic defective cells multiply faster than the immune system can kill them and a tumor forms.

If your oncologist thought hormone therapies would work for your mother, then the oncologist would be using them. You can always ask for a second opinion, but it sounds like your mother is receiving good care.

Amy, you and your mother will be in our prayers.

Lee

Thanks...
 

That's interesting and shows you how much I still need to learn. I am waiting on a call back from mom's nurse, so I'll ask her about all of this. Thanks so much for the prayers. I know we all can use them, so right back at you.
-Amy

Amy,

It sounds like your mom may be ER+ and Her2+. You should definitely confirm this with her doctor, as this does obviously impact treatment options.

Your mom was previously on Femara, which is an anti hormonal but it works differently than tamoxifen. So having one hormonal fail does not mean that NONE will work. There is also research on identifying the causes, and someday how to reverse resistance.

Since your mom had such a great response to the chemo combo, the thinking may be to back off a bit to something less taxing and see if the combination of blocking Her2 and ER will keep things stable.

If your mom is Her2+, there should ALWAYS be a Her2 targeted agent in the mix, if she is also ER+ it makes sense to block both.

The research on blocking these growth mechanisms (i.e. Estrogen or Her2 is fueling the growth) largely points to the benefits of blocking multiple pathways at the same time, that way it's harder for the cancer to find another way to grow.

good luck

Hi,

I am both Her-2 positive and Estrogen postive. My doctor always gives me Tamoxifen only after all chemo and Herceptin was over. Seems I've read somewhere that there's some kind of interference when Herceptin and Hormone treatment are used at the same time.